EMPLOYMENT APPLICATIONWINGS-BREW, INC.

Steve's Dakota Grill · Brown Derby Road House

· Willard Country Kitchen & Inn

Thank you for taking the time to complete our online
employment application. Please fill out the application below as
completely as possible. This application will take approximately 15
minutes to complete.

Personal
Information

Are you at least 18 years of age and do you have the
legal right to work in the United States?

Yes

No

First Name (Required)

Middle Name

Last Name (Required)

Social Security Number

i.e. - (123-45-6789)

Street Address / Apartment

City

State / ZIP Code

Home Phone (Required)

-
Area code and phone number

Other Phone

-
Area code and phone number

Email Address

Position Applying for:

What is the salary you desire?

Hourly Rate
Annual
Negotiable

Availability

Are you looking for a full-time career position?

Yes

No

When are you available to start?

What weekday hours are you available?

What weekend hours are you available?

How many hours are you willing to work in a
week?

Which days are you available for work?

M
T
W
T
F
S
S

How much notice will you need if a position
is offered to you?

How many miles are you willing to travel to
a position?

mi.

Are you a Veteran of the US Military?

Yes
No

If "Yes" to the above, which Branch

Date entered:

Mth
Yr

Discharge Date:

Mth
Yr

Highest Rank:

Which location are you applying for?

Have you ever worked for the TSAVARIS Corporation?

Yes
No

Do you have any disabilities which you would need accomodations in order to perform the duties of your job?

Yes
No

If "Yes" to the above, please explain

Do you have any relatives that work(ed) for TSAVARIS Corporation?

Where
Where

Have you ever been convicted of a crime?

Yes
No

(this will not, necessarily, bar you from employment), if "yes", please explain offense and disposition

Education

Enter most recent - Do not enter start and end date if
the most recent is high school

Name of School

Type of school

Street Address

City

State / ZIP Code

Start Date (Month / Year)

End Date (Month / Year)

Degree

Major Study Area

Other Studies

Recent
Employment

List most recent first

Company Name

Street Address

City

State / ZIP Code

Supervisor Name

Job Title

Job Duties

Start Date (Month / Year)

End Date (Month / Year)

Start Wage

Hourly rate
or annual salary

End Wage

Hourly rate or
annual salary

May we contact this employer for a
reference check?

Yes

No

Company Name

Street Address

City

State / ZIP Code

Supervisor Name

Job Title

Job Duties

Start Date (Month / Year)

End Date (Month / Year)

Start Wage

Hourly
rate or annual salary

End Wage

Hourly
rate or annual salary

May we contact this employer for a
reference check?

Yes

No

Company Name

Street Address

City

State / ZIP Code

Supervisor Name

Job Title

Job Duties

Start Date (Month / Year)

End Date (Month / Year)

Start Wage

Hourly
rate or annual salary

End Wage

Hourly
rate or annual salary

May we contact this employer for a
reference check?

Yes

No

References:

Name

Address

Phone Number

Relationship

I certify that the statements I have made are true and correct
and without material omission. I understand that making false
statements or omitting pertinent facts is sufficient cause for
rejection or dismissal from employment. I authorize obtaining
information from any person(s), employers, educational institutions,
licensing authorities, and/or law enforcement agencies concerning my
background, work habits, skill or conduct on the job, with the
exception of past employer(s) I have indicated that are not to be
contacted. I hereby release such person or entities from all
liability for damages for issuing such information.

By submitting this form:I authorize any person, firm, corporation or other entity to furnish any information requested by the WINGS-BREW, INC. or its agents, “Reference Checks” relative to my character, police or criminal record, employment history, educational credentials or credit history. I further release and discharge any party delivering information pursuant to his authorization from any liability, claims, charges or causes of action which I may have as a result of the delivery or disclosure of any information requested by this employer. I certify that all the statements of this application for employment are true and complete, and I understand that any false, misleading or omitted statements shall be considered sufficient cause for my immediate discharge, if employed. Further, I understand that this employment application and any other company documents or statements made should not be construed as direct, implied or inferred contracts of employment between myself and this employer, and that, if employed, my employment is for no definite period and that my employment and compensation can be terminated, with or without, just cause or without notice at any time, at the option of either myself or the employer .

Please take a moment to review your application. Indicate
that you have read the above statement by entering your initials in
the box below. To complete this application, click on the
Submit Application button.

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Initials:

This Company is an equal employment
opportunity employer. We adhere to a policy of making employment
decisions without regard to race, color, religion, sex, sexual
orientation, national origin, citizenship, age or disability. We
assure you that your opportunity for employment with this Company
depends solely on your qualifications.